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Home My WebLink About4639-zFOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z391+1 Date A~igt~t., 20 , 19 70 THIS CERTIFIES that the building located at 0sproy Nest RoaSt(loop)Street Map No. C~eavea ~ Block No. see I Lot No. ~3 ~reenport conforms substantially to the Application for Building Permit heretofore filed in this office dated ~ch ~, 19 ~ pursuant to which Building Permit No. dated ~¢h' 6 , 19 ~0, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ~ivate 'One f~,~ly d~il~g ........... The certificate is issued to V~e~o~ Os~Z~.ng ....... ~e~ ..... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of HeMth Approval .~y 2~. ~9~0 B~ R, Building InspectOr FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Ne. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ........................ t07' t3;) ~*,(e~Arz:,.5 ?az,cT ,.¢z:c:~... .................................................. ~:;:;..~...~;.~:..¥ ............ ~::~: ....... pursuon¢ to opplicotion doted ....................................................... ..~., 19Z..., ond opproYed by the Building Inspector. Fee $,...,?...q..~. Building Inspector S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. ~' ~/'/~,~'~ (~ ! TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located (Give deed location) / have been inspected by this department and found to be satisfactory. ~ 2 7 7~70 Dlstr~ot ~g~neor District Engineer I~OB~ NO. I ............................ Disapproved a/o .../..~..........~ {Bu'lding mspector~ TOWN CLERK $ OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT C~ Date ~ /~ 19 ,~O i~[ INSTRUCTIONS a. This application must be completely filled Jn by typewriter or Jn ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY/VtADE to the Building Department for the issuance of a Building Permit pursuant to the ~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ,~ Regulations, for the construction of buildings, add tons or a terations, or for removal or demolition, as here n descr bed The applicant agrees to comply with atl applicable laws, ordinances, building code, housing code, and regulations. ............... ...... State whether applicant is owner, lessee, agent, a,~~eer, general contractor, electrician, plumber or builder. If appIican:a~l~'~ ~a__cis a corporate,...~ii ature of duly~/g~thorized officer. ..... ~'~(~'~'t'~;~ '~'~orate officer) ......... 1. Locatonof andonwhich raposed work will be done ]~AapNo Street an~lumber .~..c.'~'~''. ~.~.,.~. ,/~..~..L~ ~--...o~ -~'1 -- ~'~)__~-- -- ' ..................................................................... Municipalib/ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......................................................................... . b. Intended use and occupancy ................................................................ .~. ........................................................ 3. Nature of work (check which applicable): New Building ....... ~.... Addition ..................Alteration .................. Repair .................. Removal .................. Demolition .......... Other Work (Describe) 4. Estimated Cost .................... .~...6..~..~....~..:..~...O. ................ Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... i....~. ............ Number of dwelling units on each floor .....~.. .................... If garage, number of cars ................... ..~ ................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Nurnher of Stories ............................................................................................................... .. Dimensions of same structure with a,lterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... .3..-.~.?../..~. ............... Rear ..... ~?.7../,~. ........... Depth ~/~}~"* Height ....... ./...~.:. ...... Number of Stories ................. ./." ................................................................................................. 9. Size of lot: Front .......... ..~..~. ............. Rear ....... ../..~.~. ...................... Depth ......... ~./..~.:..~..~ ......... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ............................ ~. ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... ...-~.~. .......................................... Owner of premises ..V..,..c~..?.¢.......C~...~.//1~~ ............. Address ...O..~...~.c.~....~...~s../.....~..~'..~.'/..~.f, Phone No ..................... 13. Name of Name of Architect .................. Address ...'~.....~..~..'t..'~..,~'...~.....~'....~D,,f'.'J.C~hone No ..................... Name of Contractor ../--7'..c.~......./~?.~./.c.{5......~2. ?.!./.J.c...c.....Address ..... ,Z.b~..~.......~...A,....~...c~....f~,~.~...x Phone No..?.~.~'...~..o../.~... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back ~mensions fram property lines. Give street and block or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, l:e /~9 COUNTY ~,.~ .......... ~;~.~/~;;.~ ~'~' " .............. ..'~'.~Y~;!Y~4¢ ......... ~J,~.....~. .......................................... being duly sworn deposes and says that he is the applicant (Narhd of individual Signing application) /--) _~ above named. He is the .....................................................................................................................................'~-~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ....... ....... ............. :.:....i C/ ELIZABETH ANN NEVILLE NOTARY' PUBLIC, State of New No. 52.8125850, Suffolk Cot~ty Term Expires March ~0,